Table 1.
Checklist results for medical case A
| Element | Number of teams “Yes”/initial | Number of teams “Yes”/final | Number of teams “No”/initial | Number of teams “No”/final | Likelihood Ratio* | |
|---|---|---|---|---|---|---|
| Consciousness |
10 |
10 |
0 |
0 |
||
| ABC evaluation < 2 minutes |
10 |
10 |
0 |
0 |
||
| Oxygen administration ** |
10 |
10 |
0 |
0 |
||
| Siting position ** |
10 |
10 |
0 |
0 |
||
| Monitoring | Electrocardiogram |
10 |
10 |
0 |
0 |
|
| Blood pressure |
10 |
10 |
0 |
0 |
||
| Oxygen saturation |
10 |
10 |
0 |
0 |
||
| Temperature |
8 |
9 |
2 |
1 |
0.528 |
|
| Focused clinical | Cardiac auscultation |
1 |
2 |
9 |
1 |
0.528 |
| examination | Pulmonary auscultation |
10 |
10 |
0 |
0 |
|
| Jugular veins |
0 |
1 |
10 |
9 |
||
| Signs of PVT/edema |
5 |
10 |
5 |
0 |
||
| Focused history | Anamnesis |
10 |
10 |
0 |
0 |
|
| Past medical history |
10 |
10 |
0 |
0 |
||
| Treatment |
8 |
10 |
2 |
0 |
||
| 12-lead electrocardiogram ** |
6 |
10 |
4 |
0 |
||
| Intravenous line ** |
10 |
10 |
0 |
0 |
||
| Arterial blood gases (ABG) ** |
10 |
10 |
0 |
0 |
||
| Lab tests | CBC, electrolytes, Renal &hepatic tests |
9 |
10 |
1 |
0 |
|
| C-reactive protein |
1 |
0 |
9 |
10 |
||
| NTproBNP |
8 |
2 |
8 |
2 |
1.000 |
|
| Troponin |
2 |
4 |
8 |
6 |
0.326 |
|
| D-dimers |
6 |
8 |
4 |
2 |
0.326 |
|
| Chest radiography |
10 |
10 |
0 |
0 |
||
| Cardiac ultrasound |
1 |
1 |
9 |
9 |
1.000 |
|
| Give β2mimetics |
9 |
3 |
1 |
7 |
0.004 |
|
| Noninvasive ventilation ** |
10 |
10 |
0 |
0 |
||
| Choose the mask |
8 |
7 |
2 |
3 |
0.605 |
|
| Set the ventilator correctly |
8 |
9 |
2 |
1 |
0.528 |
|
| Explain to the patient |
8 |
10 |
2 |
0 |
0.112 |
|
| Apply the mask |
10 |
10 |
0 |
0 |
||
| Observe for tolerance & synchronism |
6 |
9 |
4 |
1 |
0.112 |
|
| Observe the patient |
9 |
9 |
1 |
1 |
1.000 |
|
| Observe the ventilator |
7 |
9 |
3 |
1 |
0.255 |
|
| Repeat ABG after 30 minutes |
4 |
9 |
6 |
1 |
0.015 |
|
| Give appropriate antibiotic |
8 |
10 |
2 |
0 |
||
| Differential | Exacerbation of COPD+ pneumonia |
10 |
10 |
0 |
0 |
|
| diagnosis | Acute pulmonary edema |
4 |
10 |
6 |
0 |
|
| Acute coronary syndrome |
0 |
3 |
10 |
7 |
||
| Pulmonary embolism |
7 |
10 |
3 |
0 |
||
| Spontaneous pneumothorax |
2 |
6 |
8 |
4 |
0.063 |
|
| Correct diagnosis |
10 |
10 |
0 |
0 |
||
| Recognize β2mimetics overdose |
1 |
7 |
9 |
3 |
0.004 |
|
*
Chi-Square Tests; ** Time to achievement recorded; ABC- airway, breathing, circulation, PVT-profound venous thrombosis, CBC- complete blood count, NTproBNP- N-terminal pro b-type natriuretic peptide, COPD-chronic obstructive pulmonary disease